Doctor Name: | KATHRYN G BRODRICK |
NPI Number: | 1447326749 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | CW014097 |
Business Practice Address: | 520 Ruah Street Blossburg, PA - 16912 |
Business Phone Number: | 5706381260 |
Business Fax Number: | 5706382065 |
Mailing Address: | 105 West Ave, WELLSBORO |
State: | PA |
Postal Code: | 169011358 |
Phone Number: | 5707230620 |
Fax Number: | 5707240675 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CW014097 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |